There remains relatively little research conducted to date into whether, or how, cognitive behavioural interventions can help individuals return to work. The presented paper reviews literature and research into CBT and occupational outcomes and considers whether a return-to-work agenda may jeopardize the therapeutic alliance which is suggested to be necessary for effective CBT. Through the use of clinical examples, suggestions are made as to how employment issues might be integrated into CBT for depression and anxiety disorders. A return-to-work agenda can be utilized during therapy while maintaining a collaborative and secure therapeutic relationship, especially, perhaps if work issues are embedded within the formulation.